Abnormal lysosomes suggest toxins as etiology of chronic interstitial nephritis in agricultural communities

Using biopsy samples from various countries, Vervaet et al. demonstrated that most patients with chronic interstitial nephritis in agricultural communities (CINAC) had dysmorphic lysosomes in proximal tubular cells. CINAC (also known as chronic kidney disease of unknown origin, mesoamerican nephropathy) is a progressive chronic kidney injury occurring in agricultural laborers (mostly young men) who works in harsh tropical environment. These abnormal lysosomes were remarkably similar to those found in kidney transplant patients who received calcineurin inhibitors (CNI) for immunosuppression. The authors suggests toxins such as those found in pesticides, herbicides could have CNI properties and induces morphological change in lysosomes of proximal tubular cells.

https://doi.org/10.1016/j.kint.2019.11.009

Post-streptococcal glomerulonephritis and chronic kidney disease (CKD)

Hoy et al studied risk for CKD from post-streptococcal glomerulonephritis (PSGN) in a remote Aboriginal community. The study showed that people who had history of PSGN had increased risk in developing CKD (albuminuria, decreased GFR) later in life. Although PSGN is increasingly uncommon in developed countries, it is still prevalent in developing countries or in this case poor communities in developed country. The risk factor was scabies which leaded to skin infection with streptococci.